National Provider Identifier Database

BENJAMIN PHYSICAL MEDICINE PLC
Medical Specialty

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).


Contact Information

BENJAMIN PHYSICAL MEDICINE, PLC
373 BLAIR PARK RD
STE 206
WILLISTON, VT05495-7998
Phone: 802-522-9699
Fax:
Website:
Specialty Taxonomy Code
* Medical Specialty 261QM2500X

* Indicates primary specialty

NPI Profile & details for BENJAMIN PHYSICAL MEDICINE, PLC

NPI Number 1376075804
Legal business name
LBN
BENJAMIN PHYSICAL MEDICINE, PLC
Authorized official SCOTT BENJAMIN - (OWNER/PHYSICIAN)
Entity Organization
Organization subpart No
Enumeration date 04/03/2017
Last updated 04/03/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • VT License #: 420010625
  • NH Medicaid: 30204569
  • NY Medicaid: 02502692
  • VT Medicaid: 1009844
  • NH Other: 44146784 CIGNA
  • NY Other: 0233J1 EMPIRE BC/BS
  • VT Other: 3547305 CIGNA
  • VT Other: 699468 MVP
  • VT Other: 59537 VERMONT BC/BS

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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